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what the disability justice movement teaches us about self-care

6/2/2023

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     The self-care industrial complex (yes, I like calling things industrial complexes when I critique them; yes, this is actually an industrial complex) is worth at least 450 billion dollars today.  The way that we think about the construct of self-care has been deeply shaped by capitalism. With an endless scroll of products and tips meant to “optimize” the ways that we care for ourselves, we are being fed the idea that self-care is something that can be bought. Many of these products are marketed as biometric devices that can change your well-being from the outside in, or devices that count the “care” you are giving yourself already. ​
     This creates a system of quantifiable self-care in which users are asked to compare themselves to others, to themselves, and ultimately to their idea of “health”. The metrics available to you always tell you that you could be doing more, you could be “closing your loops”, you could be breathing better (???), you could be fitter, happier, more productive. Does this sound like obsessively checking your bank account app or trying to rack up credit card points to anyone else? What happens when the way that we form relationships with our health becomes inseparable from the ways that we navigate work and money? 
    There exists a moral judgment on the work we do for our health, those who are doing enough are good, and those not “doing enough” are told to buy more products, change their routine, set a resolution, and conform. This standard of “enough” is always shifting toward something only accessible by the richest, able-bodied, mentally well individuals. The self-criticism encouraged by the self-care industrial complex “has been shown to preoccupy us with failure and contributes to symptoms of depression, anxiety, substance abuse, and negative self-image” (Lieberman, 2018).
     The reality is that health and healing look different for everyone. Especially for people living with chronic illness or disability, the standard of “healthy” is completely personal. According to a 2022 study, serious mental illness and physical disability limit the ability to complete Activities of Daily Living (ADL). The ability to engage with anything that we could consider to be “self-care” becomes hindered by the need to complete the necessary tasks of living, ADLs, such as bathing, eating, brushing teeth, etc. What you consider to be self-care may be completely out of the picture for someone living with a chronic illness or disability. 
     I live with multiple chronic illnesses that affect my ability to consistently engage withs self-care activities. I have days when completing my ADLs feels like optimal self-care. In this way, self-maintenance can take the place of self-care. I sometimes feel as though the most self-care I can give myself is showing up for my monthly blood draws to check on my thyroid and antibody levels. I have learned that setting boundaries and taking time to rest is critical self-care for me. Doing nothing is often exactly what  I need. In a world constantly insisting that there is more I can be doing in order to support myself, this can feel like a failure. Jody Yarborough of the blog Love Disabled Life asserts that “building routines to ease pain, allowing extra time to accomplish a daily living task, and recognizing the signs of burnout far earlier than a non-disabled person might are examples of how every day is a self-care day for some folks. And this isn't out of indulgence. This is out of necessity” (Yarbrough, 2021). But, this standard of setting boundaries with yourself and others is not exclusive to people with disabilities or chronic illnesses. 
     In Leah Lakshmi Piepzna-Samarasinha’s seminal book, Care Work, she writes of the ways that she has seen crips showing up for each other. She shares some of her observations: "sharing resources and showing up, and having a spoken or unspoken rule that acknowledges that you both (the two crips in the situation) have stuff going on. You will offer what you can. You will stop when you have to. You will accept "no" to your offer without taking it personally" (Care Work p 71-72). This model of radically setting boundaries is commonplace within disability activism spaces. There is a concept called “Care Webs”, which Leah writes extensively about in her book. This is a concept that has existed in disability spaces for maybe all of time. The idea of showing up for each other, of filling in the gaps that others can’t fill for themselves, of asking for help, of saying no, and of saying yes when you can. It’s a culture of caring for each other because the systems meant to support us have proven their failures time and time again. Leah asks, “what does it mean to shift our ideas of access and care (whether it’s disability, childcare, economic access, or many more) from an individual chore, an unfortunate cost of having an unfortunate body, to a collective responsibility that’s maybe even deeply joyful?” (Care work, p. 25). 
     Living with disabilities in a world that encourages constant investment toward products and services meant to optimize our health means learning what you really need. For me, self-care looks more like cuddling my cats, going on walks with good music, and saying no. It doesn’t look like going to the gym as often as I can or tracking my heart rate religiously. The things that have helped my health the most have been free and have come from communities of people all trying their best together. If you take anything away from this, I hope it’s that it’s okay to say no and it’s okay to not make “progress”. You are existing, and that is enough.
References
  • Hauenstein, E. J., Davey, A., Clark, R. S., Daly, S., You, W., & Merwin, E. I. (2022). Self-care capacity and its relationship to age, disability, and perceived well-being in Medicare beneficiaries. Nursing Research, 71(1), 21–32. https://doi.org/10.1097/NNR.0000000000000551
  • Lieberman, C. (2018, August 10). How Self-Care Became So Much Work. Harvard Business Review. https://hbr.org/2018/08/how-self-care-became-so-much-work
  • Piepznia-Samarasinha, L. L. (2018). Care work: Dreaming Disability Justice. Arsenal Pulp Press
  • Yarbrough, J. (2021, October 14). How Disability and Self-Care Intersect. Love Disabled Life. https://www.lovedisabledlife.com/blog/how-disability-and-self-care-intersect
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using a sketchbook as a place of emotional regulation and self-awareness

12/2/2022

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 Seen as a private place for creative development and expression, the sketchbook has served an important role in the lives of artists for much of history. Artists have realized the mental health benefits of art-making and keeping a sketchbook for as long as they’ve been practicing. As an art therapist, I’m pretty convinced that the sketchbook is the greatest therapy companion of all time. An artist named Kate posted on Kandid Chronicles with her own testimonial, saying: 
“If you’re suffering from anxiety, do try something creative. It doesn’t have to be doodling or art-related, granted, but it certainly helps me everyday” (Kate, 2021)
If you’re wondering how a sketchbook could help someone with anxiety, other mental health issues, or even serve as a therapy companion, let’s break it down a bit. A sketchbook is a place for creative experimentation, and you don’t have to show it to anyone else– not even your art therapist! A 2018 article published with King Mongkut’s University of Technology Thonburi (KMUTT) defines the sketchbook as “a catchall term that covers other common designations – such as journal or notebook – that indicate a class of objects sharing similar properties and serving similar purposes. That is, they are book format, portable, personal and analogue artefacts used to record experiences,  to document reflections and to develop creative thinking” (Power, 2018).
Just making art alone can be incredibly beneficial, and even therapeutic. Studies have shown that art-making alone leads to mental well-being through encouraging play, inspiration and learning. You are welcome to use the sketchbook as a place of open exploration, but some find that intentionally exploring some themes and emotions that they are processing right now is helpful too. I like to use a combination of both of those types of sketchbooking. I find that when I don’t have a specific idea of what I am going to make, I learn something new about myself every time, and that has it’s own value in helping me gain self-awareness and form my own identity. You could use any sketchbook, or you could create a mental-health sketchbook and keep this type of work separate from any other sketchbooking you do, if you prefer. 
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​An artist named Davey Cobb wrote on Medium about the value he has found in keeping a specific sketchbook for his mental health. He lays our three groundrules “(that aren’t really rules)” for starting a mental health sketchbook (Cobb, 2022). 
“To start a mental health sketchbook remember these basic rules (that aren’t really rules):
  1. There are no rules – use it for writing, or use it for drawing, or use it for gluing in your old receipts. It doesn’t really matter what you use it for. The act of filling a book will make you feel as if you’ve accomplished something.
  2. Act with freedom – open a page and just start writing. Or just start drawing. Nobody else need ever see what’s on your pages, and so there’s nothing to fear. And you just might surprise yourself with what you come up with.
  3. Look back and smile – flip through your old sketchbooks every once in a while. It might jog your memory to a place that you once were. It might make you realise how strong you were to have overcome something. It’s good to look back, providing you are kind to yourself.”
Essentially, he asks that we just experience ourselves through the means of a sketchbook, and that we find some joy or connection to our work. 
The 2018 article entitled Re-Imagining the Sketchbook as a Medium of Encounter further clarified the purpose of the sketchbook as a place of “encounters”. That is, with the self, with the present moment, and with the artist/person’s own sense of creativity. The types of encounters that one experiences with a sketchbook can be categorized, according to the article, as reflexive, reflective, and intersubjective. These types of encounters encourage “distinctive ways of engaging self and world that, researchers argue, nurture creativity, namely, curiosity, reflection, play, experimentation, atteniveness and reflexivity” ((Bohm 2012; Claxton 2006; Csikszentmihalyi 1996) as cited by Power, 2018). The reflexive encounters are moments of “noticing the everyday world” through the sketchbook, such as drawing a subject as it moves across a field. This means that “sketchbook notations are always descriptions and interpretations”. It’s what you see, but it’s also the way that you interpreted it in that specific moment. 
The reflective encounters with the sketchbook are just what they sound like, moments of reflection and response to yourself. One participant described this as such, “I make a note or do a drawing or even just doodle to make something happen, to give myself something to think about, to force myself to respond” (Participant, as cited by Power, 2018). Reflection helps the sketchbooker develop self-awareness and an awareness of their present situation, process events and experiences, and explore what next step to take.
In intersubjective encounters, the sketchbook is used to facilitate conversation about the creative process. This part sounds like art therapy to me! Part of this is also the intentional changing of the sketchbook process by setting rules for yourself to follow and change your sketchbooking habits. Try writing about your drawing process, writing when you want to draw and vice versa, or only using your sketchbook during certain times of the day. Or just about whatever else you can think of! This process can be a place of self-discovery and growth that, in my opinion, is an amazing thing to pair with the therapeutic process.
Does anyone else want to grab their sketchbook right now? If you’re looking for inspiration, I suggest checking out The Sketchbook Project where you can explore a huge selection of uploaded sketchbooks! Start exploring!
References
  • Cobb, D. (2022, January 27). Keeping a sketchbook for your mental health. Medium. https://medium.com/p/ad60f628e2d2
  • Kate. (2020, October 16). Be creative series: Sketchbook art for mental health. Kandidchronicles.com. https://kandidchronicles.com/2020/10/16/art-for-mental-health/
  • Power, N. (2018). Article: Re-imagining the sketchbook as a medium of encounter. Art, Design and Communication in Higher Education. https://www.academia.edu/37591856/Article_Re_imagining_the_sketchbook_as_a_medium_of_encounter?email_work_card=view-paper
  • Secker, J., & Keay, J. (n.d.). Why art? Exploring the contribution to mental wellbeing of the creative aspects and processes of visual art-making in an arts and mental health course. Anglia.ac.uk. Retrieved December 3, 2022, from https://arro.anglia.ac.uk/id/eprint/702062/1/Why%20Art%20Final.pdf
  • The sketchbook project. (n.d.). Sketchbookproject.com. Retrieved December 3, 2022, from https://www.sketchbookproject.com/library/S166467
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